Provider Demographics
NPI:1902089535
Name:ADAMS, VINCENT LEE (LPTA)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:LEE
Last Name:ADAMS
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7561 FM 1960 RD E
Mailing Address - Street 2:SUITE 284
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3126
Mailing Address - Country:US
Mailing Address - Phone:956-874-3004
Mailing Address - Fax:
Practice Address - Street 1:109 W TYLER ST
Practice Address - Street 2:SUITE E
Practice Address - City:GILMER
Practice Address - State:TX
Practice Address - Zip Code:75644-2239
Practice Address - Country:US
Practice Address - Phone:956-874-3004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2033082225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant